Introduction: Circulating vitamin D concentrations have been associated with the risk of type 2 diabetes (T2D). Magnesium has also been reported to be associated with lower T2D risk. Besides, magnesium is an essential cofactor for vitamin D activation. However, the effect of dietary magnesium intake on the association between vitamin D and the risk of T2D has not been studied comprehensively. Therefore, we designed this cross-sectional study to assess the effect modification of magnesium intake on the association between vitamin D and risk of T2D.Research Design and Methods: The present study analyzed data from the National Health and Nutrition Examination Survey (NHANES) continuously from 2007 to 2014, involving 10,249 participants. By having stratified participants based on magnesium intake category (low magnesium intake <267 mg/day; high magnesium intake: ≥267 mg/day), we further evaluated the difference (interaction test) between the relationship of vitamin D with the risk of T2D among low magnesium intake participants and high magnesium intake participants using weighted multivariable logistic regression.Results: In this cross-sectional study, the association of serum vitamin D with the incidence of T2D appeared to differ between the low magnesium intake group and the high magnesium intake group (OR: 0.968, 95%Cl: 0.919–1.02 vs. OR: 0.925, 95%Cl: 0.883–0.97). Furthermore, there was evidence of interaction between vitamin D levels and magnesium intake on decreasing the incidence of T2D (p-value for interaction = 0.001).Conclusions: The results of our study indicated that magnesium intake might affect the association of serum vitamin D with the risk of T2D. Such a finding requires further randomized controlled trials to provide more evidence.

Background: Serum anion gap (AG) has been proven to be associated with prognosis in critically ill patients. However, few studies have investigated the association between AG and all-cause mortality in critically ill patients with chronic obstructive pulmonary disease (COPD). Objective: We hypothesized that the initial AG level would predict the mortality risk in critically ill patients with COPD. Methods: This retrospective cohort study was based on the Medical Information Mart for Intensive Care (MIMIC) IV database. We extracted demographics, vital signs, laboratory tests, comorbidity, and scoring systems from the first 24 hours after patient ICU admission. Multivariable logistic regression analysis models were used to explore the association between serum AG levels and mortality. Interaction and stratified analyses were conducted including age, gender and comorbidity. Results: A total of 5531 critically ill patients with COPD were enrolled, composed of 53.6% male and 46.4% female with a median age of 73 years. The all-cause mortality of these patients during ICU hospitalization was 13.7%. The risk of all-cause mortality increased as the AG level increased in the univariate logistic regression analysis (OR=1.13, 95% CI: 1.11– 1.15, p< 0.01). After adjusting for all the covariates in multivariate logistic regression analysis, the odds ratio was 1.06 (95% CI: 1.04– 1.09, p< 0.01). Compared with the lowest AG group Q1 (≤ 11mmol/L), the adjusted OR value for AG and mortality in Q2 (12– 13mmol/L) was 0.89 (95% CI: 0.63– 1.25, p=0.502), Q3 (14– 15mmol/L) was 0.95 (95% CI: 0.68– 1.34, p=0.788), and Q4 (≥ 16mmol/L) was 1.49 (95% CI: 1.10– 2.02, p=0.009) respectively. In addition, the results of the subgroup and stratified analyses were robust. Conclusion: AG is positively related to all-cause mortality in critically ill patients with COPD.

The Albumin-Bilirubin (ALBI) score, recommended for assessing the prognosis of hepatocellular carcinoma patients, has garnered attention. The efficacy of ALBI score in forecasting the risk of death in sepsis patients remains limited. We designed two cohort studies to assess the association between ALBI score and in-hospital mortality in patients with sepsis. A retrospective analysis was conducted utilizing data from the Second Affiliated Hospital of Guangzhou Medical University and the Medical Information Mart for Intensive Care IV(MIMIC-IV). Patients diagnosed with sepsis were included in the analysis. The primary outcome was the in-hospital mortality. Multivariate Cox regression analysis was conducted to assess the independent association between the ALBI score and mortality, with adjustment for potential confounders. Subgroup analysis was conducted to assess the robustness of the findings. The Guangzhou Sepsis Cohort (GZSC) of the Second Affiliated Hospital of Guangzhou Medical University comprised 2969 participants, while the MIMIC-IV database included 8841 participants. The ALBI score were categorized into < -2.60, −2.60∼-1.39, and >-1.39. After adjusting for confounders, a linear relationship was observed between ALBI score and mortality. Patients with a high ALBI grade were associated with higher in-hospital mortality in both the GZSC (HR: 1.52, 95%CI: 1.24–1.87, p < 0.001) and the MIMIC-IV database (HR: 1.57, 95%CI: 1.46–1.70, p < 0.001). A high ALBI score is associated with higher in-hospital mortality among sepsis patients in ICU.

Sepsis presents a significant healthcare challenge, characterized by high morbidity and mortality rates. There is a scarcity of relevant studies investigating the association between serum lactate dehydrogenase level and the prognosis of sepsis in patients from intensive care unit, with smaller sample sizes compared to other studies. A retrospective analysis was conducted utilizing data from the Second Affiliated Hospital of Guangzhou Medical University and the Medical Information Mart for Intensive Care IV (MIMIC-IV). The primary outcome was the in-hospital mortality. Multivariate Cox proportional hazards regression was adopted to assess the independent association. Receiver operator characteristic (ROC) curve was used to evaluate the predictive value. We included a total of 2148 patients in the Guangzhou Sepsis Cohort (GZSC) database and 5830 patients in the MIMIC-IV database. In multivariate Cox proportional hazards regression, high levels of LDH are significantly associated with higher mortality (HR = 1.21, 95% CI 1.13–1.30, p < 0.001 in the GZSC database and HR = 1.19, 95% CI 1.13–1.25, p < 0.001 in the MIMIC-IV database). The ROC curves showed that the AUC of LDH was 0.663 in the GZSC database and 0.660 in the MIMIC-IV database. A lower lactate dehydrogenase level is associated with reduced in-hospital mortality among patients with sepsis, suggesting its potential as a valuable marker for predicting prognosis in this patient population.